COVID-19 vaccines show efficacy for preventing hospitalization, death in patients with CKD
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Both BNT162b2 and CoronaVac vaccines protected patients with chronic kidney disease from COVID-19-related hospitalization and mortality, according to data published in Kidney International.
“Prior to this study, the evidence supporting COVID-19 vaccine effectiveness and safety in the CKD population has mostly been extrapolated from studies conducted among the general population,” Esther Wai Yin Chan, BPharm, MClinPharm, PhD, FSHP, associate professor in the department of pharmacology and pharmacy at the Li Ka Shing Faculty of Medicine of the University of Hong Kong, Ian Chi Kei Wong, BPharm, MSc, PhD, head of the department of pharmacology and pharmacy at the University of Hong Kong, and Franco Wing Tak Cheng, MClinPharm, lecturer from the department of pharmacology and pharmacy at the Li Ka Shing Faculty of Medicine of the University of Hong Kong, told Healio.
“Our findings are specific to the CKD patient cohort, allowing clinicians to be better informed about the risks and benefits of both vaccines for use in patients under their care,” they said. “In addition, both BNT162b2 [Comirnaty, BioNTech/Pfizer/Fosun] and CoronaVac [CoronaVac Life Sciences] are effective and thus, vaccination should not be delayed. Considerations of the benefits vs. risks of vaccines in the CKD population are important, including countries where mRNA vaccines may not be readily accessible.”
In a retrospective cohort study, researchers studied data for 28,374 non-vaccinated patients; 27,129 BNT162b2 recipients with two doses; and 47,640 CoronaVac recipients with two doses to observe if these vaccinations reduced hospitalization and mortality related to COVID-19 infection.
Data were obtained through territory-wide electronic medical records from the Hospital Authority in the Hong Kong Special Administrative Region and vaccination records from the department of health.
Effectiveness
Although both vaccines were unable to fully protect patients from a COVID-19 infection, researchers found that effectiveness of the BNT162b2 vaccine for COVID-19-related hospitalization and mortality was 64% and 86%, respectively. A reduction in these severe COVID-19 outcomes was also found for CoronaVac, with vaccine effectiveness of 44% for hospitalization and 70% for mortality.
In patients younger than 65 years old, patients on dialysis or who had a transplant, vaccine effectiveness in preventing infection was lower, particularly in those who received CoronaVac. Additionally, CoronaVac recipients who were on dialysis had a higher risk of hospitalization due to COVID-19, according to the study.
Safety
A modified self-controlled case series, excluding patients with COVID-19, was also conducted for incident adverse event of special interest (AESI) cases. It included 11,574 non-vaccinated patients; 2,589 BNT162b2 recipients; and 6,181 CoronaVac recipients.
In three doses for both vaccines, researchers found no increased risk of overall AESI when compared with baseline (BNT162b2 first dose: 0.86; second dose: 0.96; third dose: 0.60; CoronaVac first dose: 0.76; second dose: 0.86; third dose: 0.74).
According to the researchers, there will be future studies on this topic.
“In Hong Kong, people are able to choose a heterologous vaccine as their booster dose. We excluded these patients in our current study given the relatively small sample size,” Chan, Wong and Cheng told Healio. “However, with more people vaccinated with a heterologous booster dose, the effectiveness of different vaccination regimens could be examined.”
“Further, there has been discussion around the potential need for a more tailored vaccination schedule for patients with CKD, that it may not be the same as that of the general population due to their relative immune compromised status. However, as we did not specifically account for waning vaccine protection in this study, further research focusing on waning immunity may be able to address this question,” they added.
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